CPT 70160Radiology

X-ray exam of nasal bones

CPT code 70160 covers an X-ray examination of the nasal bones, typically ordered after facial trauma to check for a broken nose or other nasal bone injuries.

Showing rates for

National Average

Base Medicare rate

$36.55

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

0.17

PE RVU (NF)

0.94

MP RVU

0.02

Total RVU

1.13

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

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Billing tips

Always verify that the exam is limited to nasal bones only; if facial bones or sinuses are included in the interpretation, use appropriate alternative codes (70130, 70140, 70150)
Impact: Prevents downcoding or denials; ensures correct reimbursement level (facial bone series codes reimburse higher at $40-65 range)
Document the number and type of views obtained (minimum 2 views typically required for complete nasal bone exam)
Impact: Insufficient views may result in denial or request for medical records review; proper documentation supports medical necessity
For professional component billing (modifier 26), ensure a separate written interpretation report is in the medical record within 24-48 hours
Impact: Missing or delayed reports are a primary audit trigger; can result in complete denial of the $36.55 payment
Link to appropriate ICD-10 diagnosis codes documenting trauma or clinical indication; avoid unspecified codes when specific information is available
Impact: Specific diagnosis codes (S02.2XXA for nasal bone fracture) have higher approval rates than unspecified codes and reduce payer queries
When performed in ER setting, verify facility vs. professional fee schedule applies; do not bill professional component if employed by facility
Impact: Improper split billing can trigger compliance issues and recoupment of payments; facility-employed physicians typically cannot bill separately
Check for recent prior nasal imaging (within 30-90 days); document why repeat imaging is medically necessary to avoid duplication denials
Repeat imaging without clear justification commonly denied as not medically necessary; proper documentation can preserve the $36.55 payment

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 70160 in 2025?

The 2025 Medicare national average reimbursement rate for CPT 70160 is $36.55 for both facility and non-facility settings. This rate is based on 1.13 total RVUs multiplied by the 2025 conversion factor of 32.3465.

Can CPT 70160 be billed with other facial imaging codes on the same day?

Typically no - CPT 70160 should not be billed when more comprehensive facial bone imaging (70140, 70150) is performed, as nasal bones are included in those exams. Billing both may result in bundling or duplicate service denials unless there is clear documentation of separate medical necessity and distinct anatomic coverage.

What diagnosis codes are appropriate for billing CPT 70160?

Common ICD-10 codes include S02.2XXA (nasal bone fracture, initial encounter), S00.33XA (contusion of nose), S01.21XA (laceration with foreign body of nose), M95.0 (acquired deformity of nose), and R06.89 (nasal obstruction). Always use the most specific code supported by documentation and link to the clinical indication for imaging.

Do I need to use modifier 26 or TC when billing CPT 70160?

Use modifier 26 when billing only the professional component (physician interpretation). Use modifier TC when billing only the technical component (equipment and technician). If your practice owns the equipment and provides both interpretation and technical services, bill the complete code without modifiers to receive the full $36.55 reimbursement.

How many views are required for CPT 70160?

While CPT does not specify a minimum number of views, standard practice requires at least two views (typically lateral and Waters views) to adequately visualize nasal bone structures. Single-view exams may be challenged by payers as incomplete. Documentation should specify the views obtained.

What is the difference between CPT 70160 and 70140?

CPT 70160 covers X-ray examination of nasal bones only, while CPT 70140 covers X-ray examination of facial bones with less than three views. Code 70140 is more comprehensive and includes nasal bones plus other facial structures, reimbursing at a higher rate. Use 70160 only when examination is specifically limited to nasal bones.

What are the work RVUs for CPT 70160 in 2025?

The 2025 work RVU for CPT 70160 is 0.17, with practice expense RVU of 0.94 (both facility and non-facility) and malpractice RVU of 0.02, totaling 1.13 RVUs. These values reflect the relatively low complexity and time required for nasal bone radiography and interpretation.